No Joy and No Fun

Last week, I found myself asking one of the harder questions I've been faced with in motherhood: What to do with all of my son's Melissa & Doug chunky puzzles. When I found myself worrying about how the puzzles wouldn't fit in the shelf supposedly designed for them, I realized that, in yet another way, I was unprepared for many of the practical aspects of being a mother. I also realized that, if this worry was top on my list, on the whole, I was doing okay.

In the months before I became a mother, in part because of my family mental health history and in part because of my professional awareness, I'd tried to do as good a job as possible preparing myself emotionally for what lie ahead. In truth, I'd done much less work preparing myself for the practical things, like where to put all the stuff that goes with the kid.

During my pregnancy, I noticed that a lot of people actually spend a lot of time preparing for the practical - acquiring all the various baby accoutrements, changing work schedules, moving to neighborhoods with good schools. Those preparations aren't easy, but they are concrete and measurable, things you can put on a checklist.

Preparing emotionally for becoming a mother is not comparable. It feels a little like the weather - you can make an educated guess, but sometimes you don't know it's going to rain until it's pouring.

In the 18 months since I became a mother, I've had quite a few friends have babies, too. It has been hard to watch as many, some first-time mothers and some not as new to the game, have faced serious mental health challenges. When the New York Times ran a series on maternal mental health (specifically, the wide range and timing of mental health challenges in pregnancy and parenting) I was glad to see the coverage.

As Christiane Manzella of the Seleni Institute has said, Pam Belluck's series "put maternal mental health exactly where it should be: on the front page." Over the five years that I've blogged about mental health on a site devoted to psychology, I've watched mainstream media coverage of mental health increase to such an extent that even if I blogged daily, I couldn't cover the coverage. As a mental health professional and a person who's passionate about mental health issues, front page, viral coverage of these issues is good news.

Ideally, the impact of sharing these stories is something that helps mothers - more social support for getting help, more training for mental health professionals in working with women on these issues, or greater political advocacy that could lead to increased access to mental health services. I admire the bravery of each of the women featured and have great respect for their honesty.

And yet, balanced with seeing these portrayals of women's realities as a good thing was a not-good feeling I couldn't shake.

From a personal standpoint, it was very hard to read these stories without analyzing my own thoughts and behaviors. As I considered what to write about here, I kept finding myself stuck, wondering if the good - having this information out there for all the reasons outlined above - outweighs the possibility of having a lot of mothers who worry that their normal thoughts and behaviors are anything but.

As I think my example at the beginning of this piece makes clear, as mothers, we struggle enough with the basics. What is the line between spending time "obsessing" about your child and a diagnosable mental health condition? In parenting, there are many there-but-for-the-grace-of-G-d-go-I moments, the seconds between a "normal" thought about your child and something verging on dangerous.

“Symptoms can overlap, but it's especially important to differentiate between postpartum psychosis, a rare psychiatric emergency, and postpartum depression. When a new mother struggles with postpartum psychosis, the risk of harming herself or her baby is small but real, and she requires immediate medical attention.

It's also important to know that a woman’s fears about the safety and health of her baby do not mean that she is at imminent risk of harming him. More than 90 percent of all new mothers do have scary thoughts that reflect reasonable concerns about their baby's safety and health. For a woman who develops a perinatal mood disorder (such as depression, anxiety, and obsessive-compulsive disorder), these concerns often escalate and cause significant distress but do not put her at risk for harming her baby.

It is equally important to understand that even if a woman's experience does not include thoughts about her child being harmed, she can still be suffering from a perinatal mood disorder and benefit from treatment.”

I know that there is no “quick fix” for maternal mental health, and that treatment is hard and not always accessible. But, what is powerful about having more people talking about mental health is that it makes it a bit easier to ask for help. The aptly phrased paradox of modern parenting as “all joy and no fun” may be true. But, it’s not supposed to be no joy and no fun.